Use this form to register for the trail adventure day event on 5/2. Registration will close on 4/16 at 5pm. No exceptions. Questions? Contact Holly at heritagetrailsulholly@gmail.comPlease enable JavaScript in your browser to complete this form.Troop Number (If not in a current troop, write in Juliette) *Girl Level(s) (Daisy, Brownie, Junior, Cadette, Senior, Ambassador) *Leader or Registered Adult Participating *FirstLastName of contact person for groupEmail *Email of contact personAre you a registered Girl Scout? *YesNoLeader/Adult Emergency Contact Name *FirstLastLeader/Adult Emergency Contact Phone *Phone of contact personGirl participantsGirl participant 1 *FirstLastIs this girl a registered Girl Scout? *YesNoGuardian name for girl participant 1 *Girl participant 1 phone number *Girl participant 1 contact email for guardian *Girl participant 2FirstLastIs this girl a registered Girl Scout?YesNoGuardian name for girl participant 2Girl participant 2 phone numberGirl participant 2 contact email for guardianGirl participant 3FirstLastIs this girl a registered Girl Scout?YesNoGuardian name for girl participant 3Girl participant 3 phone numberGirl participant 3 contact email for guardianGirl participant 4FirstLastIs this girl a registered Girl Scout?YesNoGuardian name for girl participant 4Girl participant 4 phone numberGirl participant 4 contact email for guardianGirl participant 5FirstLastIs this girl a registered Girl Scout?YesNoGuardian name for girl participant 5Girl participant 5 phone numberGirl participant 5 contact email for guardianAdult participantsAdult participant 1 FirstLastIs this person a registered Girl Scout?YesNoAdult participant 1 phone numberAdult participant 1 contact emailAdult participant 2FirstLastIs this person a registered Girl Scout?YesNoAdult participant 2 phone numberAdult participant 2 contact emailAdult participant 3FirstLastIs this person a registered Girl Scout?YesNoAdult participant 3 phone numberAdult participant 3 contact emailAdult participant 4FirstLastIs this person a registered Girl Scout?YesNoAdult participant 4 phone numberAdult participant 4 contact emailAdult participant 5FirstLastIs this person a registered Girl Scout?YesNoAdult participant 5 phone numberAdult participant 5 contact emailPayment OptionsPlease indicate how you will pay for Trail Adventure DayCredit card (select below how many girls will attend)Check (please mail check by April 9th)If mailing a check, please send to PO Box 22 Mehoopany, PA, 18629. Made out to SoCA.If you are paying online now, how many girls will attend? ($10 per girl, adults free)012345678910Total$ 0.00Additional informationIf you have additional adults/girls please add them here and note if they are registered or not and contact information then include them in the total number of people attending in the drop down box above.Credit/Debit CardCardName on CardPlease note: You will need to sign the GSHPA COVID-19 wavier prior to participating. Contact GSHPA at memberservices@gshpa.org for information. *I understandSubmit Share this:TwitterFacebookLike this:Like Loading...